Asbestos Re-Survey Audit Form (proposed)

• Site Address

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• Yes

  No

  N/A

• Original Surveyor

• Date of Audit Re-Survey

  Date

• Original Project Number

• Original Scope of Survey

  Select Management Refurbishment Demolition Management with targeted Refurbishment or Demolition

  • Management
  • Refurbishment
  • Demolition
  • Management with targeted Refurbishment or Demolition

• Client

• Audit conducted by

• Audit Reference Number

• Property Type

  Domestic

  Commercial

  Industrial

• Property designation

  Select House Flat Bungalow Residential Care Office Warehouse or unit Communal Area Other

  • House
  • Flat
  • Bungalow
  • Residential Care
  • Office
  • Warehouse or unit
  • Communal Area
  • Other

• Have you identified samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• Further samples to be taken during Re-survey audit

  Yes

  No

  N/A

• Sample Number

• Room Name/Number

• Material Description and Location

• Extent

• Product type

• Condition

• Surface Treatment

• Asbestos Type

• Material Assessment Score

• We're all ACMs or suspected ACMs Identified and sampled

  Yes

  No

  N/A

• Please list suspected ACMs that were missed

• We're Presumed or Strongly Presumed items valid

  Yes

  No

  N/A

• What items were not valid?

• We're intrusive inspections thorough enough for targeted areas

  Yes

  No

  N/A

• Explain why?

• Was the site left in a clean and tidy state as per client specification and plan of work

  Yes

  No

  N/A

• Explain why?

Non Conforming Works

• Were any NCW Identified during the audit

  Yes

  No

Follow Up Actions

• Are Corrective Actions Required

  Yes

  No

• Annual Audit Required

  Yes

  No

• Is Retraining Required

  Yes

  No

• Does the Surveyor Need to be Withdrawn from Site Surveys until Further Notice

  Yes

  No

• Is an Effectiveness Check Required

  Yes

  No

• Has the 3 Month Assessment been Completed

  Yes

  No

• Is Additional Training Required

  Yes

  No

Conclusion

• Summary of Re-survey audit

• Has the Audit been Compliant

  Compliant

  Non-Compliant

  N/A

Acknowledgement

• I confirm the information above is an accurate and true reflection of the site observations

  Yes

  No

  N/A

• Auditor Name

• Auditor Signature

  Sign

• Date

  Date